PROJECTSUMMARY/ABSTRACT Despitesignificantadvancesintreatment,heartfailure(HF)continuestobetheleadingcauseof hospitalizationsamongolderadultsintheU.S.,withanestimatedannualcostof$32billion.Poorself- managementinolderadultswithHFcausespooradherencetobehaviorrecommendations,delaysin recognizingHFhealthcrisesandseekingclinicalassistance,leadingtofrequenthospitalizations,impaired functionalstatus,andpoorqualityoflife.However,recentlarge-scalestudiesofinterventionsdesignedto supportHFself-managementhavesufferedfromchallengesoflowerthananticipatedrecruitmentas participantswererequiredtotraveltointerventionsites,beingcomparedwithusualcareprogramsthatwere exceptionalbutexpensiveandhumanresource-intensiveorfailuretoengageparticipantstillendofstudy periods.Onepromisingapproachistheuseofsensor-controlleddigitalgames(SCDG),whichofferaffordable, portable,scalabletoolstofacilitateengagementinHFself-managementbehaviorsthatshowthepoorest adherence?weightmonitoringandphysicalactivity?whilebeingenjoyableandeasytouse.Theprimarygoal ofthisstudyistoobtaininitialefficacydataandundertakeacomprehensivefeasibilityassessmentofaSCDG interventionthatsynchronizeswithaBluetooth-enabledweightscaleandactivitytrackertoactivategame rewardsandfeedbackbasedonolderadultHFparticipants?real-timeweightmonitoringandexercise behaviors.InAim1,wewillassessthepreferences,andacceptabilityoftheSCDGamong10olderadultswith HFduringformativedesignprocess.InAim2,tomotivateparticipants?engagementinHFself-management behaviors,wewilldevelopaSCDG(?SafeatHome?)informedbyFogg?sbehavioralmodel,utilizinganarrative inwhichthegoalistohelpanavatarinthegameavoidre-hospitalizationandassessits?usability.Aim3will evaluatetheinitialefficacyoftheSCDGinterventionforprimaryoutcomeofrateofengagementinHFself- managementbehaviorofweight-monitoringandsecondaryoutcomesofphysicalactivityengagement,HFself- management-knowledge,andself-efficacy,HF-functionalstatus,hospitalization,andqualityoflife.Forthis study,wewillrecruitolderadultsdiagnosedwiththeNewYorkHeartAssociation?sHFclassificationItoIIIfrom out-patientHFsettingsincentralTexas,andwewillrandomize44patientstoeithertheSCDGintervention groupthatwillreceivesensorstrackingweightmonitoringandactivityandplaytheSCDGonamobile smartphonefor12weeksoracontrolgroupthatwillreceivesensorsandanapptrackingactivityandweight monitoring,andstandardizedwrittenHFeducationalmodules.Aim4willdeterminethefeasibilityoftheSCDG interventionandwillformthebasisfordesigningafuturelargerandlongerrandomizedcontrolledclinicaltrial. Ourprojectwillgeneratemuchneededinsightandguidancefordigitalgamingsolutionstomotivateadherence toHFself-managementbehaviorsandimprovethehealthoutcomesofolderadultswithHF.